Prevalence of rheumatoid factor in asymptomatic chronic hepatitis B surface carriers in the context of endemic malaria: cross-sectional study at University Hospital of Cocody, Abidjan, Côte d'Ivoire

Abstract

Introduction: rheumatoid factor is an autoantibody involved in autoimmune diseases and certain chronic infections. Chronic hepatitis B, common in Côte d'Ivoire, leads to prolonged antigenic stimulation and chronic inflammation, which may promote rheumatoid factor production. This study aimed to determine the prevalence of rheumatoid factor and to identify factors associated with rheumatoid factor positivity in asymptomatic chronic carriers of hepatitis B surface antigen in a hospital setting in Abidjan, Côte d´Ivoire.

Methods: a prospective cross-sectional study was conducted in 2024 at the University Hospital of Cocody in Abidjan, Côte d'Ivoire. A total of 120 asymptomatic chronic carriers of hepatitis B surface antigen without autoimmune diseases or active malaria were enrolled. Clinical and demographic data were collected. Rheumatoid factor was measured by immunoturbidimetry with a positivity threshold of >14 IU/mL. Multivariable logistic regression analysis was used to identify factors associated with rheumatoid factor positivity.

Results: the prevalence of rheumatoid factor positivity was 12.5% (95% CI: 6.54-18.46). The mean age of participants was 36.4 ± 11.2 years, and 60% were male. Advanced age (≥30 years) was independently associated with rheumatoid factor positivity (aOR: 3.32; 95% CI: 1.06-10.39; p = 0.04). No significant association was found with sex or reason for consultation.

Conclusion: in this hospital-based population of asymptomatic chronic carriers of hepatitis B surface antigen, advanced age was associated with rheumatoid factor positivity. Monitoring rheumatoid factor in older carriers may help improve the assessment of autoimmune risks and diagnostic accuracy.